Your heart health is an essential component of your overall well-being. The heart is responsible for pumping important nutrients and blood-filled oxygen throughout your body, the foundation for your health.
Being proactive about your heart health means taking the time to understand your health, and taking smart action with nutrition and lifestyle to gain control and prevent future health complications. Oftentimes, additional qualified support can help reach your goals, such as a psychologist, personal trainer, and a Registered Dietitian who specializes in your area of health.
During your physical exam, your doctor will order a series of blood tests or a cardiac panel which will typically offer clues about your overall health and may determine your risk for certain heart conditions. However, it can be confusing to sift through various lab tests to determine what they might mean for your heart health. And oftentimes they lack certain tests to fully assess your heart attack risk.
This article will review which blood tests detect heart problems and what these tests tell you about your heart health to empower you to become an active participant in your care. For a full list of which blood tests to obtain, what they mean and what the optimal range is for heart health, enroll in my self paced “how to read your blood tests for optimal heart health” blood test course here.
Comprehensive Metabolic Panel (CMP)
A comprehensive metabolic panel (CMP) is a test that measures 14 different substances in your blood to help gain information about your body’s chemical balance and metabolism.
More specifically, a CMP will offer insight into your kidney function, electrolyte balance, liver function, and thyroid function.
While these lab tests will provide important information about your body systems, it may also offer clues about your heart health.
For example, if your CMP shows that your electrolytes are unbalanced, particularly potassium and calcium, you could have a higher risk of developing abnormal heart rhythms.
Additionally, a CMP will check your blood sugar or glucose levels. Blood glucose levels that are high could mean that you have prediabetes or diabetes, both of which can increase your risk of heart disease.
When your blood sugar remains chronically high, it can damage the blood vessels and nerves that control your heart. Over time, this damage can lead to heart disease.
The link between high blood sugar and heart disease is strong. In fact, people with diabetes are 2 to 4 times more likely than others to develop cardiovascular disease. As a result, cardiovascular disease remains the most common cause of death in people with diabetes.1
Beyond a simple blood sugar test, your should look at insulin markers like HOMA-IR and fasting insulin levels to be able to prevent diabetes early. Your insulin levels will increase earlier than your blood sugar will if you have insulin resistance and are at risk for diabetes.
HOMA-IR or Homeostatic Model Assessment of Insulin Resistance evaluates how much insulin your pancreas needs to make in order to control your blood sugar levels. A high HOMA-IR indicates that your body is using more insulin than normal to keep your blood sugar balanced and is a sign of insulin resistance.
Fasting insulin measures the level of insulin found in your blood. High fasting insulin levels can indicate insulin resistance and type 2 diabetes which can increase your risk for heart disease.
Oftentimes these tests aren’t requested, and knowing what to ask can help you be more proactive. I recommend testing them and advise individuals to do so in my self-paced blood test course.
Inflammatory markers in heart health
Research suggests that inflammation within the walls of your arteries can lead to plaque formation which can increase your risk of heart disease.2
High sensitivity C-reactive protein (HsCRP) and Lp-PLA2 blood tests can be used in a cardiac panel to identify increased inflammation in your body so you have a better understanding of your risks.
High Sensitivity C-reactive protein (hsCRP)
CRP is a protein made by your liver and is produced at higher levels when your body is stressed as a result of an infection, injury, or another inflammatory process.
A high level of hsCRP in the blood has been linked to higher underlying inflammation and in turn a higher risk of atherosclerosis. Atherosclerosis is the buildup of fatty plaques in blood vessels which can lead to a heart attack or a stroke.
Lp-PLA2 (Lipoprotein-associated phospholipase A2)
Lp-PLA2 is an enzyme that appears to promote inflammation and plaque formation on your artery walls. Research suggests that having high CRP and Lp-PLA2 levels can increase your risk of ischemic stroke. 3
Oftentimes these two tests need to be requested, and I recommend testing them in your annual blood test and advise individuals to do so in my self-paced blood test course.
Lipid Profile
A lipid profile or a cardiac panel can be used by you and your doctor to determine your risk of heart and blood vessel disease. Along with a lipid profile, there are many other components we need to analyze to assess your risk factors like age, family history, medical history, gut health, other medical tests, and your lifestyle to develop a treatment plan.
Total cholesterol
Your total cholesterol is the sum of all of the parts of your blood cholesterol. This includes your LDL cholesterol, your HDL cholesterol, and other lipid components. Elevated total cholesterol may indicate that you are at a higher risk of developing heart disease.
LDL cholesterol (low-density lipoprotein)
Your LDL cholesterol, also known as your “bad cholesterol”, can contribute to the buildup of plaque on the walls of your arteries. This buildup can lead to blockages which increase your risk for a heart attack or stroke.
HDL cholesterol (high-density lipoprotein)
Your HDL cholesterol, also known as your “good cholesterol”, can help remove bad cholesterol from your blood, keeping your arteries open and flowing with ease. Therefore, high HDL cholesterol levels may help protect your heart.
Non-HDL cholesterol (non-HDL-C)
Non-high density lipoprotein cholesterol (non-HDL-C) is determined by subtracting your HDL cholesterol from your total cholesterol.Your non-HDL-C includes a measure of all the “bad” types of cholesterol which can lead to hardened arteries. Studies show that non-HDL-C fraction may be a better marker of risk than total cholesterol or LDL cholesterol. 4
Triglycerides
Triglycerides are a type of fat in your blood. High triglyceride levels can contribute to atherosclerosis, narrowing your arteries and increasing your risk of heart disease.
Advanced Cardiac Panel
In addition to a cardiac panel that measures your triglycerides and cholesterol levels, an advanced lipid panel can help further assess your risk for heart disease and help with creating a personalized treatment plan for you to optimize these numbers. Unfortunately this is not always routine, but knowing to ask for it can help understand how likely your cholesterol has the potential to turn into dangerous plaque. I recommend requesting an advanced lipid panel to my private clients and advise everyone to do so in my self-paced blood test course.
An advanced lipid panel is especially useful for people with diabetes, insulin resistance, or cardiovascular disease who continue to have progression of disease despite having their cholesterol in an optimal range.
Lipoprotein (a)
Lipoprotein (a) is LDL cholesterol attached to a protein called apoprotein (a). Your levels of lipoprotein (a) are often determined by your genetics. Higher levels of lipoprotein (a) can increase the risk of a buildup of plaque in your arteries and, in turn, your risk of heart attack and stroke. If you have an elevated lipoprotein(a) levels, you want to take a more proactive approach to reduce your risk of heart attacks and strokes.
Apolipoprotein B (ApoB)
Apolipoprotein B is the main protein found in your LDL cholesterol. High levels of ApoB may indicate that you are at higher risk for developing heart disease. In fact, research suggests that testing ApoB may be a better overall marker of heart disease risk than LDL alone. 5
LDL particle number (LDL-P)
Your lipid profile will measure the amount of LDL cholesterol you have in your blood, but an LDL particle number will evaluate the number of LDL particles in your blood.
Having a high number of LDL particles can lead to the formation of fatty plaques on your artery walls which can increase your risk for heart attack and stroke. I got into more detail about this is in my blog post titled, “What a high LDL numbers means for atherosclerosis: what a top cardiac dietitian wants you to know.”
LDL size
Evaluating the size of your LDL particles may be a useful tool in determining your risk factor for heart disease.
LDLs particles that are generally small and dense can increase your risk of heart disease compared to having particles that are larger and less dense.
Therefore, looking beyond a simple LDL value can provide important insight into your risk.
Cardiac Markers
Cardiac markers are chemicals that are released into the blood when your heart is damaged or stressed. These tests are often conducted after a person may have experienced a cardiac event.
Some common cardiac markers include:
- Troponin
- Creatine kinase (CK)
- Myoglobin
If you have had a cardiac event, your doctor may also request these tests.
Getting support to interpret your blood tests
According to the American Heart Association a whopping 80% of cardiovascular diseases, including heart disease and stroke are preventable. Being an active participant in your health means understanding your blood tests for heart health and subsequently taking action through science-based nutrition and lifestyle management. Knowing your numbers is the first line of defense against heart disease and allows you to be your own advocate to support your health and well-being.
If you are confused about what your numbers mean for you, which tests you need to ask for, or anything related to interpreting your blood work or cardiac panel, I created a 60-minute course just for you. During this self paced blood test course, we will review everything you need to know about how to interpret your blood work and what to do next. Learn more about “How to read your blood tests for optimal heart health” here.
If you need help optimizing the above parameters, join my next 6 week heart optimization group program or learning more about my 1 to 1 services.
References:
- Diabetes and Heart Disease, Assessed May 10, 2022.
- Sachdeva, A., Cannon, C. P., Deedwania, P. C., Labresh, K. A., Smith, S. C., Jr, Dai, D., Hernandez, A., & Fonarow, G. C. (2009). Lipid levels in patients hospitalized with coronary artery disease: an analysis of 136,905 hospitalizations in Get With The Guidelines. American heart journal, 157(1), 111–117.e2.
- Ballantyne, C. M., Hoogeveen, R. C., Bang, H., Coresh, J., Folsom, A. R., Chambless, L. E., Myerson, M., Wu, K. K., Sharrett, A. R., & Boerwinkle, E. (2005). Lipoprotein-associated phospholipase A2, high-sensitivity C-reactive protein, and risk for incident ischemic stroke in middle-aged men and women in the Atherosclerosis Risk in Communities (ARIC) study. Archives of internal medicine, 165(21), 2479–2484. https://doi.org/10.1001/archinte.165.21.2479
- Kathariya G, Aggarwal J, Garg P, Singh S, Manzoor S. Is evaluation of non-HDL-C better than calculated LDL-C in CAD patients? MMIMSR experiences. Indian Heart J. 2020;72(3):189-191. doi:10.1016/j.ihj.2020.05.008
- Shapiro MD, Fazio S. Apolipoprotein B-containing lipoproteins and atherosclerotic cardiovascular disease. F1000Res. 2017;6:134. Published 2017 Feb 13.
- American Heart Association: CDC Prevention Programs, Assessed May 10, 2022. https://www.heart.org/en/get-involved/advocate/federal-priorities/cdc-prevention-programs
